保乳术联合乳房整形术对乳腺癌患者术后乳房美观度及并发症的影响

Effect of Breast Conserving Surgery Combined with Breast Plastic Surgery on Postoperative Breast Aesthetics and Complications of Breast Cancer Patients

目的:探讨保乳术(Breast conserving surgery,BCS)联合乳房整形术对乳腺癌患者术后乳房美观度及并发症的影响。方法:选取医院2019年3月-2020年5月收治的乳腺癌患者119例,根据选取手术方法不同分为对照组(n=57)和研究组(n=62),对照组行BCS治疗,观察组在对照组基础上联合乳房整形术。观察两组围术期并发症发生情况;随访1年,统计分析两组术后乳房美观度及生活质量变化,并记录两组术后并发症发生情况。结果:住院期间,研究组切口裂开、血肿及切口感染发生率均低于对照组,差异有统计学意义(P<0.05)。术后6个月,两组情绪角色、躯体功能、肢体疼痛、社会功及总体健康评分均高于术前,且研究组术后乳房美观度、简明健康量表36(Shortform-36,SF-36)各指标评分均高于对照组,差异有统计学意义(P<0.05)。随访1年,两组术后皮瓣坏死、脂肪坏死、皮肤皱缩及肿瘤复发发生率比较,差异均无统计学意义(P>0.05)。结论:BCS联合乳房整形术能有效改善乳腺癌患者术后美观度,安全性较好。

Objective To investigate the effect of breast conserving surgery(BCS)combined with breast plastic surgery on breast aesthetics and complications of breast cancer patients after surgery.Methods A total of 119 breast cancer patients admitted to the hospital from March 2019 to May 2020 were selected and divided into the control group(n=57)and the study group(n=62)according to different surgical methods.The control group was treated with BCS,and the observation group was treated with breast plastic surgery on the basis of the control group.The two groups were observed for perioperative complications The occurrence was followed up for 1 year.The postoperative breast aesthetics and quality of life changes in the two groups were statistically analyzed,and the postoperative complications were recorded in the two groups.Results During hospitalization,the incidence of incision dehiscence,hematoma and incision infection in the study group were lower than those in the control group,the differences were statistically significant(P<0.05).At 6 months after surgery,the emotional role,physical function,limb pain,social function,and overall health scores of the two groups were higher than before operation(P<0.05).And the postoperative breast aesthetics and SF-36 index scores in the study group were higher than those in the control group(P<0.05).After 1 year of follow-up,there were no significant difference in the incidence of skin flap necrosis,fat necrosis,skin shrinkage and tumor recurrence between the two groups(P>0.05).Conclusion BCS combined with breast plastic surgery can effectively improve the postoperative aesthetics of breast cancer patients and have good safety.